Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 2005 Sep;81(959):549–551. doi: 10.1136/pgmj.2004.031005

Use of the single subject design for practice based primary care research

J Janosky 1
PMCID: PMC1351074  NIHMSID: NIHMS5086  PMID: 16143681

Abstract

The use of a single subject research design is proposed for practice based primary care research. An overview of the rationale of the design, an introduction to the methodology, strengths, limitations, a sample of recent literature citations, a working example, and possible clinical applications are presented.

Full Text

The Full Text of this article is available as a PDF (54.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Balestra D. J., Balestra S. T., Wasson J. H. Ulcerative colitis and steroid-responsive, diffuse interstitial lung disease. A trial of N = 1. JAMA. 1988 Jul 1;260(1):62–64. [PubMed] [Google Scholar]
  2. Guyatt G. H., Heyting A., Jaeschke R., Keller J., Adachi J. D., Roberts R. S. N of 1 randomized trials for investigating new drugs. Control Clin Trials. 1990 Apr;11(2):88–100. doi: 10.1016/0197-2456(90)90003-k. [DOI] [PubMed] [Google Scholar]
  3. Guyatt G. H., Keller J. L., Jaeschke R., Rosenbloom D., Adachi J. D., Newhouse M. T. The n-of-1 randomized controlled trial: clinical usefulness. Our three-year experience. Ann Intern Med. 1990 Feb 15;112(4):293–299. doi: 10.7326/0003-4819-112-4-293. [DOI] [PubMed] [Google Scholar]
  4. Guyatt G., Sackett D., Taylor D. W., Chong J., Roberts R., Pugsley S. Determining optimal therapy--randomized trials in individual patients. N Engl J Med. 1986 Apr 3;314(14):889–892. doi: 10.1056/NEJM198604033141406. [DOI] [PubMed] [Google Scholar]
  5. Jaeschke R., Cook D., Sackett D. L. The potential role of single-patient randomized controlled trials (N-of-1 RCTs) in clinical practice. J Am Board Fam Pract. 1992 Mar-Apr;5(2):227–229. [PubMed] [Google Scholar]
  6. Kearns K. P. Flexibility of single-subject experimental designs. Part II: Design selection and arrangement of experimental phases. J Speech Hear Disord. 1986 Aug;51(3):204–214. doi: 10.1044/jshd.5103.204. [DOI] [PubMed] [Google Scholar]
  7. Kratochwill T., Alden K., Demuth D., Dawson D., Panicucci C., Arntson P., McMurray N., Hempstead J., Levin J. A further consideration in the application of an analysis-of-variance model for the intrasubject replication design. J Appl Behav Anal. 1974 Winter;7(4):629–633. doi: 10.1901/jaba.1974.7-629. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Langer J. C., Winthrop A. L., Issenman R. M. The single-subject randomized trial. A useful clinical tool for assessing therapeutic efficacy in pediatric practice. Clin Pediatr (Phila) 1993 Nov;32(11):654–657. doi: 10.1177/000992289303201103. [DOI] [PubMed] [Google Scholar]
  9. Larson E. B., Ellsworth A. J., Oas J. Randomized clinical trials in single patients during a 2-year period. JAMA. 1993 Dec 8;270(22):2708–2712. [PubMed] [Google Scholar]
  10. Larson E. B. N-of-1 clinical trials. A technique for improving medical therapeutics. West J Med. 1990 Jan;152(1):52–56. [PMC free article] [PubMed] [Google Scholar]
  11. Lashner B. A., Hanauer S. B., Silverstein M. D. Testing nicotine gum for ulcerative colitis patients. Experience with single-patient trials. Dig Dis Sci. 1990 Jul;35(7):827–832. doi: 10.1007/BF01536795. [DOI] [PubMed] [Google Scholar]
  12. McReynolds L. V., Thompson C. K. Flexibility of single-subject experimental designs. Part I: Review of the basics of single-subject designs. J Speech Hear Disord. 1986 Aug;51(3):194–203. doi: 10.1044/jshd.5103.194. [DOI] [PubMed] [Google Scholar]
  13. Robin E. D., Burke C. M. Single-patient randomized clinical trial. Opiates for intractable dyspnea. Chest. 1986 Dec;90(6):888–892. doi: 10.1378/chest.90.6.888. [DOI] [PubMed] [Google Scholar]
  14. Wagner J. L., Winett R. A. Prompting one low-fat, high-fiber selection in a fast-food restaurant. J Appl Behav Anal. 1988 Summer;21(2):179–185. doi: 10.1901/jaba.1988.21-179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Woolf G. M., Townsend M., Guyatt G. Treatment of cryptosporidiosis with spiramycin in AIDS. An "N of 1" trial. J Clin Gastroenterol. 1987 Dec;9(6):632–634. doi: 10.1097/00004836-198712000-00005. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES